Neuropsychiatry Group: Brain abnormalities in psychosis

Professor Maria Ron

The
Group’s focus is on the study of patients with first episode psychosis.
This programme of research, in collaboration with Professor Eileen
Joyce, aims to describe cognitive and brain structural phenotypes at
illness onset in order to exclude the effects of aging, medication and
other environmental factors.

The study funded
by a programme grant from the Wellcome Trust, takes advantage of new
imaging methodologies (MTR and diffusion tensor imaging [DTI]) able to
detect subtle changes before volumetric changes become apparent. We
have completed a 3 year follow-up study of first episode schizophrenia
and a study of the corpus callosum using DTI. The follow-up study
suggest that, although volumetric brain abnormalities are present at
the onset of the disease, there is no conclusive evidence to suggest
that they progress in these initial years. The lack of DTI
abnormalities in the corpus callosum at this initial stage contrast
with the myelin changes detected in chronic patients, suggesting that
some neuropathological abnormalities may be progressive, or that they
occur only in a subgroup of patients that go on to follow a chronic
course.

In an attempt to examine neural correlates
of cognition in psychosis we completed a study of patients with bipolar
disorder (Professor Maria Ron and Dr Stefania Bruno in collaboration
with Dr Lisa Cipolotti, Department of Clinical Neuropsychology, NHNN).
BPII (Bipolar II) patients, in whom depressive episodes are prominent,
had more severe deficits than BPI (Bipolar I) patients (with marked
hypomania). IQ deficits correlated with reduction of MTR in the left
temporal regions and with volume changes in frontal white matter.

In
collaboration with Professor David Miller, we are looking at early
imaging predictors of cognitive impairment in a cohort of patients
recruited at onset of disease and now followed up for five years. Early
prediction of cognitive deficits may allow more effective therapeutic
interventions in the future. This study, which is funded by a programme
grant from the MS Society, will continue for the next two years.